Evensen Helge, Hjermstad Marianne Jensen, Cvancarova Milada, Kristensen Vendel, Larssen Lene, Skattum Jorunn, Hauge Truls, Sandstad Olav, Medhus Asle W
Department of Gastroenterology, Oslo University Hospital, Norway.
Faculty of Medicine, University of Oslo, Norway.
Endosc Int Open. 2022 Dec 15;10(12):E1570-E1576. doi: 10.1055/a-1968-7682. eCollection 2022 Dec.
Knowledge on self-reported quality of life (QoL) in achalasia and QoL improvements after peroral endoscopic myotomy (POEM) is limited. Furthermore, the clinical role of QoL in achalasia follow-up has not been evaluated. The present study aimed to examine QoL in achalasia patients before and after POEM and assess associations between QoL, Eckardt score (ES) and objective results. This was a single-center prospective study of treatment-naïve achalasia patients with 12-month follow-up after POEM including manometry, upper endoscopy, 24-hour pH registration, and timed barium esophagogram. QoL data were registered using European Organisation for Research and Treatment of Cancer core questionnaire (QLQ-C30) and esophageal module (QLQ-OES18). Comparison with a reference population was performed to assess impact of achalasia on QoL and effect of therapy. Mixed models for repeated measures were applied. Fifty patients (26 females) with a median age of 47 years (18-76) were included. Before treatment, all QoL domains were significantly impaired compared with an age- and gender-adjusted reference population ( < 0.05). No significant QoL-differences were found after POEM, except for fatigue and nausea/vomiting. Clinically relevant QoL improvement was observed in ≥ 50 % of the patients in all QoL domains, except for physical and role functioning. QoL was significantly associated with ES ( < 0.05) but not with objective results. Achalasia is associated with severe QoL impairment. Following POEM, a significant and clinically relevant QoL improvement is observed. QoL is associated with ES, but not with objective results after POEM.
关于贲门失弛缓症患者自我报告的生活质量（QoL）以及经口内镜下肌切开术（POEM）后生活质量改善情况的知识有限。此外，生活质量在贲门失弛缓症随访中的临床作用尚未得到评估。本研究旨在检查POEM前后贲门失弛缓症患者的生活质量，并评估生活质量、埃卡德特评分（ES）与客观结果之间的关联。这是一项单中心前瞻性研究，对未经治疗的贲门失弛缓症患者进行了POEM术后12个月的随访，包括测压、上消化道内镜检查、24小时pH值记录和定时食管钡餐造影。使用欧洲癌症研究与治疗组织核心问卷（QLQ-C30）和食管模块（QLQ-OES18）记录生活质量数据。与参考人群进行比较，以评估贲门失弛缓症对生活质量的影响和治疗效果。应用重复测量的混合模型。纳入了50例患者（26例女性），中位年龄为47岁（18 - 76岁）。治疗前，与年龄和性别调整后的参考人群相比，所有生活质量领域均有显著受损（P < 0.05）。POEM术后未发现显著的生活质量差异，除了疲劳和恶心/呕吐。在所有生活质量领域中，≥50%的患者观察到具有临床意义的生活质量改善，但身体和角色功能领域除外。生活质量与ES显著相关（P < 0.05），但与客观结果无关。贲门失弛缓症与严重的生活质量受损相关。POEM术后，观察到生活质量有显著且具有临床意义的改善。生活质量与ES相关，但与POEM后的客观结果无关。
